Reduced mobilization of CD34+ stem cells in advanced human immunodeficiency virus type 1 disease

Granulocyte colony-stimulating factor (r-met Hu G-CSF; filgrastim; 10 mu g/kg/day for 7 days) was used to mobilize CD34(+) stem cells into the peripheral blood of human immunodeficiency virus type 1 (HIV-1)-infected individuals and a group of HIV-1-uninfected donors as a measure of immunologic reserve in HIV-1-infected people. G-CSF mobilized CD34(+) cells of HIV-1-infected individuals with cell counts >500 CD4(+) cells/mm(3), as well as in HIV-1-uninfected donors. In contrast, CD34(+) cell mobilization was significantly blunted in HIV-1-infected individuals with cell counts <500 CD4+ cells/mm(3) (<200 cell days vs. >650 cell days, P < .0005, compared with the >500 CD4(+) cell cohort). At least 1.75 X 10(7) CD34(+) cells were harvested by leukapheresis from patients in each study cohort. CD34(+) cell viability and the ability to differentiate precursor cells into myeloid and erythroid progenitor cells were not affected by HIV-1 infection.